Technology Becoming Key to Personalized Patient Care at UCSF

A mock-up of a room at the future UCSF Benioff Children's Hospital at Mission Bay with a multimedia wall.

A man with a rare form of cancer sits in his longtime doctor's office, where the two of them discuss the latest innovations in treatment with a UCSF cancer specialist located hundreds of miles away.

A diabetic woman uploads data from her blood sugar monitor into UCSF's secure online patient portal and then participates in a personalized quality-of-life survey — all from the comfort of her kitchen.

A child hospitalized with cystic fibrosis interacts with fellow patients and friends back home through a large video screen on the wall of his room at the UCSF Benioff Children's Hospital.

These are a few of the many scenarios expected to unfold in the coming years as UCSF implements ever-more-advanced technologies designed to make life easier for patients and care providers, and help break the cycle of treating individuals only after they're sick. Some of the changes will coincide with the planned opening in 2015 of the new UCSF Medical Center at Mission Bay, a state-of-the-art hospital complex designed to accommodate the best current technologies and evolve over time as new innovations arise.

"Technology is the lynchpin for all of us to engage in keeping patients well," said Dr. Seth Bokser, medical director of information technology at the UCSF Benioff Children's Hospital and co-chair of the Mission Bay IT executive steering committee. "We need to move from a system of sick care to a system of health care."

Encouraging Interaction Through Technology

Certain tools, such as the increased use of telemedicine, are already in the pipeline. UCSF recently launched a pilot program deploying telemedicine interaction with some of its referring pediatric hospitals so that local health care providers can interact in real time with both a patient in the community and a UCSF expert participating remotely. Alternatively, a provider whose patient is being treated at UCSF's children's hospital can stay apprised of his or her condition from afar.

By the time the new UCSF Benioff Children's Hospital opens at Mission Bay, that program is expected to extend to all pediatric referring hospitals, Bokser said. The medical center at Mission Bay also will offer technology-based educational and entertainment options to patients that aren't available at the current medical center at Parnassus Heights.

"We have many patients who are too sick to get up and get around or be around other children because of their infectious issues," said Michael Towne, manager of Child Life Services at UCSF Benioff Children's Hospital. "We see kids with cystic fibrosis having conversations with each other out in the hallway, standing 12 feet apart, doing anything they can to connect with another human being."

Towne says the display screens on the walls of each patient room in the 289-bed medical center now under construction at Mission Bay could prove transformative for such patients.

"Imagine if you could Skype from room to room, or to family members who are back at home. Or if you could upload photos from your favorite vacation and cover the screen with them, like wallpaper," he said. "We currently have a teen lounge where patients can share their war stories, but imagine if we were able to have a virtual teen lounge that every patient could take part in. We look forward to exploring those possibilities."

The benefits of such technologies will extend to the new specialty hospitals for women and cancer patients as well, said Dr. Elena Gates, chief of the UCSF Division of General Gynecology, who has been closely involved in the medical center planning process.

"It will be like bringing people to a virtual meeting," she said of the media walls. "Currently, in our birthing center, people bring in laptops and we see family members all over the world gathering to watch a birth remotely. In the future, we would make it easier for them to experience that special moment or, if someone comes into the cancer hospital for chemotherapy and has a support network back at home, they would be able to have a group visit remotely."

Gates also envisions pregnant women who are restricted to their hospital rooms attending a childbirth class or other group activities through a live video feed.

Towne predicts the media walls will make it easier to educate patients and their loved ones about specific medical conditions and what to expect after they leave the hospital, as well as provide basic but valuable information such as the hours of the hospital playroom. Child Life Services recently debuted an internal TV channel at the hospital dedicated to providing such information.

Making Use of Mobile Digital Devices

The expanding pool of health-focused online games and social media features will help engage patients of all ages in new ways and "make health maintenance and improvement fun," Bokser added. Using the example of a weight-loss app that allows users to share and compare their progress, Bokser said "game-ification" will create support networks among patients with similar conditions or health-improvement goals.

One key to sticking with such goals over the long term is developing tools that are both quick and convenient, Bokser said. In the coming years, UCSF hopes to offer its patients ways to integrate their health monitoring devices — from oxygen-saturation monitors to EKGs — directly into the UCSF MyChart portal, which allows patients to interact with their electronic medical records and communicate with doctors and clinic staff from home. More than 10,000 patients have signed up since MyChart was launched last spring.

"In a lot of cases now we keep patients in the hospital for monitoring so that we know right away when their biometric data deviate one way or the other," Bokser said. "But we're moving into an age where we're going to be able to discharge patients to their homes and monitor them in real time through secure, remote technology."

Bokser said the ability to upload blood glucose data into MyChart likely will come within the next year or two, as will the ability for UCSF to conduct valuable quality-of-life and outcome surveys directly through the portal. He estimated that integrating other biometric monitors will take about five years.

Of course, with the increased capabilities of services like MyChart comes an increased need to ensure that patients' privacy is protected at all times. UCSF is firmly committed to patient confidentiality and already has developed policies within MyChart that focus on the special needs of certain groups, Bokser said. For example, UCSF has created specialized electronic After-Visit Summaries and Patient Portal formats for adolescents that balance access to personalized health information and education with the need for adolescent confidentiality and safety.

"We want to make sure we're educating and empowering our patients," Bosker said, "but not presenting anything they developmentally can't handle or endangering them by providing information that gets into the wrong hands."

About UCSF Medical Center
UCSF Medical Center consistently ranks as one of the top 10 hospitals in the United States. Recognized for innovative treatments, advanced technology, collaboration among health care professionals and scientists, and a highly compassionate patient care team, UCSF Medical Center serves as the academic medical center of the University of California, San Francisco. The medical center's nationally preeminent programs include children's health, the brain and nervous system, organ transplantation, women's health and cancer. It operates as a self-supporting enterprise within UCSF and generates its own revenues to cover the operating costs of providing patient care.

About UCSF Benioff Children's Hospital
UCSF Benioff Children's Hospital creates an environment where children and their families find compassionate care at the forefront of scientific discovery, with more than 150 experts in 50 medical specialties serving patients throughout Northern California and beyond. The hospital admits about 5,000 children each year, including 2,000 babies born in the hospital. For more information, visit www.ucsfbenioffchildrens.org.